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Here's a new snapshot case straight from the UK… We have a 32 year old male, normally fit with no history whatsoever. He has had a stressful week (personal issues), and decided maybe a 4 mile run might help. It didn't. When he returned home, he developed sudden onset of chest discomfort, and decided to […]

This is the discussion to "63 year old male: "Dental Pain". You may wish to review the case. For starters, i think we all agree that the patient, with his signs and symptoms, needs to be transported. We have all had patients like this who don't want to go, even though we know they should. […]

Here's a case submitted by a faithful reader who wishes to remain anonymous. He has submitted several cases before and they are always excellent so thank you, Mr. Anonymous! EMS is called to the residence of a 69 year old female who is complaining of sudden onset of shortness of breath and weakness. Past medical […]

Here is an interesting case submitted by Adam Frederick, NREMT-Intermediate. As usual, some details have been changed to protect patient confidentiality. EMS is called to the local Urgent Care for a 63 year old male complaining of upper jaw pain related to "dental work". He had made two trips to the dentist this past week […]

I was just watching the "podmedic" Jamie Davis interview Physio-Control's VP of Marketing Cam Pollock and noticed another video of Jamie interviewing Ted Setla from Setla Films and First Responders Network about the Code STEMI Web Series. You can watch the first two episodes of the Code STEMI Web Series and all the behind the […]

Click HERE! In this episode Tom Bouthillet sits down with Christopher Granger, M.D., Mayme Lou Roettig, R.N and James Jollis, M.D. from the RACE Program in North Carolina. In the course of our "unplugged" session some incredible insights are developed from one of the highest functioning STEMI systems in the United States! See also: Episode […]

This is the conclusion to 88 year old male CC: Chest pain. You may wish to go back and review the history and clinical presentation. First, let's look at the rhythm strip. This shows an undetermined regular rhythm at a rate of about 60 with demand ventricular pacing. This is an oversimplification but as long […]

EMS is called to a 88 year old male with a chief complaint of chest discomfort. On arrival the patient meets EMS at the front door. His skin is slightly pale and moist. He appears anxious. Past medical history: "Cardiac", pacemaker, hypertension, dyslipidemia Medications: Numerous, unavailable at the time of EMS evaluation Paramedics lead the […]

This is the discussion for our "Snapshot" case, 58 year old male CC: Epigastric pain. You may wish to review the case before continuing. Thanks to all of you, we had a lot of great comments! Many of you had wished we had a rhythm strip to analyze… keep in mind, this 12 lead is a […]

From time to time, we may have an interesting ECG, but without enough information (including final diagnosis) or additional ECGs to make a full case study. In these instances, we will share the ECG and whatever information we have in our "Snapshot" series. As always, some information may be changed to protect patient confidentiality. Hope […]

Ken Grauer58 Year Old Male, Workout Worry@ Eli — I don’t see AFlutter. That is, I see no indication of regular atrial activity at a rate consistent with AFlutter. Instead, the rhythm is irregularly irregular without P waves = AFib at a controlled ventricular response. In my opinion, one doesn’t need Sgarbossa criteria here to activate the cath lab. So, yes the…
2018-09-13 02:09:24

Vince DiGiulioIs epinephrine harmful in cardiogenic shock?Sorry about that; I copied the quote from the article and my browser automatically changed the "μ" to an "m". Thanks for noticing, and thanks for pointing it out in the most passive-aggressive manner possible.
2018-09-12 16:45:26

Ken Grauer, MDElectrocardiographically Silent High Lateral STEMI EquivalentHi Tom. This is a great case — so NICE that you posted it for others to learned from. But as I commented several times when you sent this case around to our group — the T waves in V2,V3 are disproportionately peaked and transition occurs early (between V1-to-V2) — so the chest leads are NOT…
2018-08-14 08:38:03

Eli58 Year Old Male, Workout WorryAnybody else see the possibility of a LBBB or A-Flutter? I'm not sure if this will make any difference with the treatments but im just trying to interpret it first because if there is a LBBB then it does not meat Sgarbossa criteria and if it is A-Flutter that could explain the hyper acute T's…
2018-07-20 21:29:21